Michael Miller, MD, DFASAM
Chair, WISAM Public Policy Committee
In February, the U.S. Attorney’s Office for the Western District of Wisconsin sent letters to Wisconsin physicians encouraging them to take a step back and “take stock of” their practices and their prescribing patterns in light of the opioid epidemic. While the letter indicated the recipient was not under any sort of investigation by federal prosecutors, the outcomes left a chilling effect on physicians to receive such a letter from prosecutors in the U.S. Department of Justice.
After hearing of these letters, I immediately reached out to Mark Grapentine, JD, Senior Vice President for Governmental Relations at the Wisconsin Medical Society, to gauge the reaction of the Wisconsin physician community and to discuss next steps. In short order, consensus developed to prepare a joint press release as well as a joint letter from WMS and WISAM to the U.S. Attorney’s office in Madison.
Very quickly, a cordial response was received with a suggestion to meet in person and discuss each party’s respective perspectives. The U.S. Attorney’s office expressed a desire to be collaborative with the medical community regarding identifying solutions to the opioid overdose crisis. On April 1st, a meeting convened in Madison with representatives from WMS, WISAM and the Wisconsin Hospital Association, met with five attorneys from the Western District of Wisconsin, three attorneys from the U.S. Attorney’s office for the Eastern District of Wisconsin, three representatives from the Wisconsin Attorney General’s office including Deputy Attorney General Eric Wilson, and a representative of the Drug Enforcement Administration’s office in Milwaukee. Also in attendance was Tim Westlake, MD, from Wisconsin Medical Examining Board and the Wisconsin Controlled Substances Board, which overseas controlled substances prescribing within our state and which is the current administrator of the Wisconsin PDMP.
U.S. Attorney for the Western District, Scott Bader, provided opening comments and shared the directive received by DOJ from the White House to take immediate action to reduce opioid overdose deaths. Discussion ensued regarding the scope of the opioid problem and the current role of the U.S. Attorney’s offices around the country. Actions that have been taken by the DOJ, including the distribution of letters to various subsets of physician prescribers, were shared, and Mr. Bader made clear the intention of the U.S. Attorneys’ offices was to form a partnership with all aspects of the medical community in Wisconsin and collaborate to best address the opioid epidemic to generate positive public health outcomes.
The dialogue that has been established between the U.S. Attorney’s office has been very positive. Despite tensions that arose because of the DOJ letters being distributed to Wisconsin physicians without consultation with WMS or other physician groups, the collaboration that has developed through this effort marks a strong relationship for the future.
WISAM President-Elect Dr. David Galbis-Reig and I have both been invited to present and participate in planning the DOJ’s 2019 Opioid/Meth Summit, Making Progress through Collaboration and Prevention. The conference will take place October 15-16 at the Grand Geneva Resort in Lake Geneva. Last year’s Summit featured U.S. Senator Hal Rodgers from Kentucky and attracted over 700 attendees.